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Doctor insights on: I Had A Stress Test Which Is Reported As Equivocal Should I Have A Cardiac Cath Done

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I had a stress test which is reported as equivocal. Should I have a cardiac cath done?

I had a stress test which is reported as equivocal. Should I have a cardiac cath done?

Not necessarily: Cardiac caths are used to identify blockages in the arteries that supply blood to the heart. The idea, which makes intuitive sense, is that if a significant blockage is present, it can be opened with a balloon or a stent, presumably decreasing the chances of a heart attack in the future. This has not been shown to be true. The available evidence doesn't show cath treatment superior to meds alone. ...Read more

Dr. Heidi Fowler
3,152 Doctors shared insights

Stress (Definition)

Stress affects most people in some way. Acute (sudden, short-term) stress leads to rapid changes throughout the body. Almost all body systems (the heart and blood vessels, immune system, lungs, digestive system, sensory organs, and brain) gear up to meet perceived danger. These stress responses could prove beneficial in a critical, life-or-death situation. Over time, however, repeated stressful situations put a strain on the body that may contribute to physical and psychological problems. Chronic (long-term) stress can have real health consequences and should be addressed like any other health concern. Fortunately, research is showing that lifestyle changes and stress-reduction techniques can help people learn ...Read more


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My heart doctor wants me to have a Cardiac catheterization after telling him I am having chest pain but I had a nuclear stress test no blockages?

My heart doctor wants me to have a Cardiac catheterization after telling him I am having chest pain but I had a nuclear stress test no blockages?

He may be right: Chest pains can be caused by coronary artery disease or by unrelated causes. If your pain is brought on by exertion, then I would favor that you undergo cardiac catheterization as the nuclear stress test is not 100% reliable. I personally have had such an expereince that nuclear test was fine but it missed significant narrowing of coronary arteries which was only detected on coronary artery cathet ...Read more

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Cardiology I have been having chest pain on exertion for a couple of years. After a stress test and a cardiac catheterization, the blockage is too small and behind the heart and hard to reach to place a stent. I am on plavix, zocor, (simvastatin) ecotrin,

Your: Your exertional chest pain (angina) is a result of poor blood flow to the region of your heart supplied by this small artery. Based on your description, this sounds like a lower-risk lesion for serious complications like major heart attack or sudden cardiac death; and so would not warrant surgical bypass or higher-risk stenting. The good news for you is that a recent large clinical trial (courage study) has taught us that this type of blockage is treated very effectively with aggressive medical therapy. You are already on good drugs, but you may benefit from increased doses and/or the addition of newer anti-anginal therapy like Ranolazine (ranexa). If you have not already been referred to cardiac exercise rehab, this may also help relieve your angina. ...Read more

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Spect images demonstrate inferior and apical reversibility from my nuclear stress test. Is a cardiac catherization must be done?

Spect images demonstrate inferior and apical reversibility from my nuclear stress test. Is a cardiac catherization must be done?

Not enough data...: Inferior ; apical reversibility means there is some ischemia in those regions. Without seeing the images it is difficult to tell how much. If there is very mild ischemia, some cardiologists may decide to do medical management (only medicines). If there is any significant amount of ischemia, cardiac catheterization is usually done. Again, it depends on the clinical scenario. Not enough data. ...Read more

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Extremely lightheaded after Cardiac stress test, but it came back completely normal. Report showed no abnormalities. Is the lightheadedness okay?

Extremely lightheaded after Cardiac stress test, but it came back completely normal. Report showed no abnormalities. Is the lightheadedness okay?

Depends: It all depends on how long you ran for on the treadmill. If there were no arrhythmias noticed. It most likely was just related to strenuous exercise. But if it persists I would seek medical attention. ...Read more

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Dr. Nayleh mumneh to answer- yes I have been checked for cardiac issues- had halter monitor, stress test, chest xrays, ekgs, and peek flow test done?

Dyspnea: Ok so that is ruled out, then you need to be checked for asthma, you need to see a pulmonologist or allergist and have a decent pulmonary function test, as a peak flow is only a crude measurement of lung function. ...Read more

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Ct scan of coronary arteries done in ER says 70% block or artifact. Follow up nuclear stress test 100% normal cardiologists says. What to think now?

Ct scan of coronary arteries done in ER says 70% block or artifact. Follow up nuclear stress test 100% normal cardiologists says. What to think now?

Heart...: Cardiac ct is anatomic imaging. Nuclear stress is more functional imaging. Without seeing your ct it is hard to say but if there was a calcified plaque in the coronary, a blooming artifact is possible. If nuclear stress was normal, that's great. You may still have coronary disease which is not hemodynamically significant. You are young for significant heart disease. Discuss with your doctor. ...Read more

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What cardiac diagnoses can a stress test determine?

What cardiac diagnoses can a stress test determine?

Stress test: Indicates exercise aerobic capacity, possible presence of ischemia or arrhythmia. ...Read more

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What is the name of the cardiac stress test drug?

What is the name of the cardiac stress test drug?

Cardiac stress test: There are various drugs we use during cardiac stress testing with imaging. For routine treadmill or bicycle exercise stress testing without imaging, no drugs are used. When we do perfusion imaging we use thallium 201 or sestamibi for the imaging. We do use adenosine and other agents to facilitate the myocardial perfusion imaging especially if exercise isn't done. ...Read more

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Statistically speaking, what are the chances of a cardiac event in the first year lets say after a normal nuclear stress test?

Statistically speaking, what are the chances of a cardiac event in the first year lets say after a normal nuclear stress test?

Very low: Studies have quoted different numbers based on type of stress (exercise vs. Pharmacologic), length of follow up, patient population, etc. Overall, the risk is very low, well below 5%, reported around 1%/yr after a normal study in the below listed study.
Jacc cardiovasc imaging. 2012 oct;5 (10):1014-21. ...Read more

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How precise is a nuclear cardiac stress test?

Nuclear stress: All tests have sensitivity and specificity and each lab has its own data. In the best labs these values for this test are >85% sens/spec., there are many technical factors. We choose tests by the information needed and the best test o get us what we need to know. ...Read more

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What is the average cost of a cardiac nuclear stress test?

Varies: It varies depending on type of stress e.g. Treadmill or which pharmaceutical. It also varies by location if you do it in a doctor's office or clinic or hospital. Practices charge a wide range too. A wide range from 400s to 900s or higher for cash patients. What insurances pay and copays may be a lot different.
http://health. Costhelper. Com/stress-tests. Html. ...Read more

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Which are cardiac emergency precautions during tc99 stress test?

Which are cardiac emergency precautions during tc99 stress test?

Nuclear stress test: These tests are performed with ECG and blood pressure monitoring and with emergency drugs and defibrillator usually available in the room. ...Read more

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What are cardiac emergency precautions taken during tc99 stress test?

What are cardiac emergency precautions taken during tc99 stress test?

Mibi stress test: The study is done with ECG and BP monitoring with emergency equipment readily available if needed ...Read more

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Is there a test that is comparable to the nuclear cardiac stress test?

Is there a test that is comparable to the nuclear cardiac stress test?

Depends: It depends what your doctor is looking for. Ultrasound, cardiac ct and MRI may be able to show how strong your heart is beating (ejection fraction) and if there is any wall motion abnormalities. Cardiac ct and MRI can even look at the vessels, which nuclear scans cannot. However, nuclear cardiac scans are considered the standard of care for looking at how well the blood perfuses the heart tissue. ...Read more

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Is it possible to have major cardiac side effects after a chemical stress test?

Is it possible to have major cardiac side effects after a chemical stress test?

Yes: Can precipitate an ischemic event, if

stress relates in decreased coronary

flow during maximum stress. ...Read more

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I'm afraid to take a nuclear cardiac stress test because it sounds radioactive. Is it dangerous?

I'm afraid to take a nuclear cardiac stress test because it sounds radioactive. Is it dangerous?

Nope: There is radioactivity involved, but the dose is not considered in the range that it presents a risk and is comparable with other radiology exams. If a physician is ordering the exam, there is typically a good reason that would present more of a "risk" than the nuclear scan. I would not worry about the word "nuclear" in the test and take care of your heart. ...Read more

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Is cardiac MRI stress testing safer than cardiac angiogram? I'm really worried about my MRI stress test tomorrow.

Is cardiac MRI stress testing safer than cardiac angiogram? I'm really worried about my MRI stress test tomorrow.

Yes, since: MRI is relatively noninvasive, and angiogram requires catheterization. The tests do not provide the same information, however. MRI looks for ischemic or infarcted myocardium, which cannot be readily diagnosed on angiography. Each test has its own limitations and indications. ...Read more

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What is the reliability of a nuclear stress test? Particularly with regard to ruling out angina / cardiac related chest discomfort?

What is the reliability of a nuclear stress test? Particularly with regard to ruling out angina / cardiac related chest discomfort?

Angina: A nuclear perfusion test in the right lab can reliably indicate whether abnormal myocardial perfusion is present. Angina pectoris is a symptom of abnormal myocardial perfusion. A positive perfusion study in a good lab has greater than 90% specificity and a negative test slightly less. Some labs are not as good as others as with any study. ...Read more

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4 episodes of NSVT OVER LAST 6 months, longest being 15 beats. (Almost fainted) Normal cardiac MRI, stress test, etc... Should I have EP study??

4 episodes of NSVT OVER LAST 6 months, longest being 15 beats. (Almost fainted) Normal cardiac MRI, stress test, etc... Should I have EP study??

See an electrophysio: See an electrophysiology ASAP with copies of all your medical records to date ASAP. You need either an ablation or the correct medicines once the underlying diagnosis is made. ...Read more

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Can I request of the technician that when I take a cardiac treadmill stress test that the platform be on a horizontal level rather than an incline?

Can I request of the technician that when I take a cardiac treadmill stress test that the platform be on a horizontal level rather than an incline?

Less accurate test: The "bruce" protocol stress test was designed to increase the incline and speed every 3 minutes. A horizontal test may not stress the heart enough, before the participant has to stop. Sometimes signs of heart disease do not show until the higher levels, thus a non-standardized test might miss heart disease, thus being less reliable. You can discuss other types of stress testing with your doctor. ...Read more

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Sharp pain woke me up in upper rt shoulder. Cardiac related? Neg nuc stress test 1 yr ago & neg gb scan. Lt shoulder hurts also rotate & upper back

Sharp pain woke me up in upper rt shoulder. Cardiac related? Neg nuc stress test 1 yr ago & neg gb scan. Lt shoulder hurts also rotate & upper back

MSK issue: Brooke,
Since more serious medical have been excluded, I would consider seeing an MSK specialist (sports/ortho). This may be muscular, myofascial, shoulder pathology. In addition these areas tend to be where we store "stress" and can manifest as physical symptoms. I would first consider being evaluated for musculoskeletal (MSK) causes. Physical therapy may be needed. ...Read more

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Caffeine ok while having a chemical cardiac stress test using dipyridamole, persantine?

Caffeine ok while having a chemical cardiac stress test using dipyridamole, persantine?

NO!!!!: Caffeine should not be ingested prior to pharmacologic cardiac stress since it can interfere with the results. Stopping caffeine ingestion for at least 24 hours prior to pharmacologic stress should be sufficient. If caffeine is ingested and pharmacologic stress is performed, this can cause false negative results. If you have taken caffeine, stress may be rescheduled or switched to dobutamine. ...Read more

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Which test is more accurate a cardiac petscan or thallium stress test? Why is one or the other chosen by cardiologists?

Which test is more accurate a cardiac petscan or thallium stress test? Why is one or the other chosen by cardiologists?

PET over thallium: Both tests use nuclear isotopes. The isotope used in pet scans has better visualization/resolution characteristics than thallium which is a spect study (like technetium).
Tissue viability is also superior in pet as compared to thallium.
The problem is usually that pet is done in fewer cardiology systems than spect (technetium or thallium)
of the spect scans, technetium is superior to thallium. ...Read more

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What would cause what appears to be telangiectasias to form on the skin after having a cardiac PET scan/stress test? Is this a common side effect?

What would cause what appears to be telangiectasias to form on the skin after having a cardiac PET scan/stress test? Is this a common side effect?

Don't know - not awa: I'm not aware of any drug that causes telangiectasias other than alcohol. Alcohol will do it over time, and they can appear in clusters depending on the underlying conditions. Go see your doctor or use HealthTap Prime to get more information. ...Read more

Dr. Francis Uricchio
360 Doctors shared insights

Cardiac Catheterization (Definition)

This is a procedure where narrow, flexible tubes are inserted into a peripheral artery through a cut in the skin, and advanced to the heart. Dye can be injected through the catheters into the arteries of the heart to look for blockages ("angiogram"), or to measure pressure within the cardiac chambers ("right heart cath"). Arteries can be opened with balloons/stents at the ...Read more


Dr. Oscar Novick
3 Doctors shared insights

Stress Test (Definition)

A stress test is a cardiac test which can include walking on a treadmill and monitoring your heart while you are walking. They can also inject you with a nuclear material and do a more comprehensive scan on your heart to check for blockage. They can also do a chemical stress test which omits the need to ...Read more